[spidermonkey09]

It's how the flu vaccine works and how a developed coronavirus vaccine would work.

I'd summarise that quote as - you can get flu more than once, the vaccine (or developed immunity) lasts a year so get it every year.

I suppose my takeaway is that we don't have a vaccine or developed immunity and wont for a significant period of time. Seems a significant gamble to me (Times editorial today quite good on this). Usual caveats that I know fuck all of what I'm talking about apply.

[Offwidth]

I disagree: experts seem to think mortality rates are reliably estimated now. 0.5 to 1% where in control and 3% to 5% where not. That's certainly the line from WHO.

Where are lockdown boredom and herd immunity regarded as critical factors in the correct national response to this pandemic according to WHO. Why is Britain so special? ?

I'm worried about what government experts say publicly as we don't know the balance they are bending against. Yesterday's announcement was political, and will be weighing infection against perceived economic damage. I think they have it wrong on both counts as I believe the epidemiology is clear now: that with the reported levels we have, stopping cross infection in public is crucial. On economics I expect if parts of the NHS crash then the length of the crisis the level of panic and economic damage will be much worse.  China messed up initially in Wuhan but it only took a month to get things under control, yet they used methods the UK can't consider, unless things become truly horrible. The big Eastern economies appear to have the infection under control with faster harsher action.

[Offwidth]

Previous pandemics didn't show major repeat waves of infections. It's not happened in China... nearly all their new infections are from people travelling to China from outside and seem to be being contained. These major Eastern economies don't expect most people to be infected eventually (from extensive testing in places like Korea maybe a fraction of a percent at most) to build herd immunity, so why do we? This UK government information is not consistent with that coming from WHO, nor other countries based on their best advice.

Look at the new cases curve in Korea. From a similar level to where we, in the UK, are now they are close to back to the same level in less than a month. Thats what proper state action results in. Remember Korea were unlucky as they had an early superspreader in a cult community.

https://www.worldometers.info/coronavirus/country/south-korea/

https://www.businessinsider.com/south-korean-official-tests-positive-coronavirus-doomsday-church-cult-2020-2?r=US&IR=T

[abarro81]

RE: Ru's questioning of UK policy, and questions around immunity, Germany appears to be thinking along the same lines (broadly):

"This morning at a regular press conference which the head of the Robert Koch Institute, the leading public health and safety body in Germany has been holding for the past two and a half weeks, its director, Lothar Wieler said [...]

Wieler said that between 60-70% of the population would get the virus, due to the fact that it is new, there is no immunity against it, no vaccination against it and no treatment for it” and that “many many people” will have had it already without knowing it, and will have already recovered. Those numbers are unquantifiable, but the more people who get it, long term, the better, as that will increase the immunity levels.

Four-fifths of people will get it very mildly with many not even realising they have it, he added."

[Duma]

no climbing trips for ondra:

https://news.expats.cz/coronavirus-in-the-czech-republic/breaking-czech-republic-to-close-borders-from-march-16-barring-residents-from-leaving-and-tourists-from-entering/

[dunnyg]

I hope the world is ready for some grotty local limestone boulder eliminates, 9A and harder...

[Nails]

I have a cunning plan.

In theory you could isolate all the people in high-risk groups and their carers, whilst deliberately infecting all the people in low-risk groups. Those infected wouldn't have to be isolated and could even go to work if they felt up to it.

There's bound to be a few selfish types who would refuse deliberate infection. They would just have to sit it out with the high-risk group. 2 to 3 weeks down the line and we're all done and dusted.

I admit you may struggle to get this past the ethics committee. 

[highrepute]

I'd summarise that quote as - you can get flu more than once, the vaccine (or developed immunity) lasts a year so get it every year.

I'm not sure how you get that summary. It's a quote about coronaviruses, not flu vaccines.

Flu and Corona (and common cold) are both viruses. They behave in the same way. I think it sounds quite scary to say you can get corona-virus multiple times and if you have immunity it only last a year. But saying the same about flu doesn't seem so bad because we know it to be the case and we live with it every year.

[Ru]

Flu and Corona (and common cold) are both viruses. They behave in the same way. I think it sounds quite scary to say you can get corona-virus multiple times and if you have immunity it only last a year. But saying the same about flu doesn't seem so bad because we know it to be the case and we live with it every year.

The quote doesn't say that immunity only lasts a year, it says that people with other corona viruses have been purposely, successfully and symptomatically reinfected after a year. A straight reading of the quote does not imply that that re-infection could not have occurred earlier or that there was any immunity developed prior to reinfection.

The situation is different to flu, because Covid-19 is many times worse in terms of mortality and morbidity (I note very little is being said about survivors that are left with significant lung and other organ damage) and because the whole point of the government strategy is an assumption that immunity is developed so that widespread infection is desirable. The point of the quote was to question the basis of that assumption.

[Ru]

I have a cunning plan.

In theory you could isolate all the people in high-risk groups and their carers, whilst deliberately infecting all the people in low-risk groups. Those infected wouldn't have to be isolated and could even go to work if they felt up to it.

There's bound to be a few selfish types who would refuse deliberate infection. They would just have to sit it out with the high-risk group. 2 to 3 weeks down the line and we're all done and dusted.

I admit you may struggle to get this past the ethics committee. 

On the contrary, I think that is almost exactly the government's plan. Albeit we have not had advice to isolate at risk groups as yet.

[spidermonkey09]

Flu and Corona (and common cold) are both viruses. They behave in the same way. I think it sounds quite scary to say you can get corona-virus multiple times and if you have immunity it only last a year. But saying the same about flu doesn't seem so bad because we know it to be the case and we live with it every year.

Except there are obviously lots of different flu's because the viruses mutate all the time. The flu vaccine varies in efficacy each year because medical professionals have to take a punt on which will be the most prevalent strain that year.

As Ru says, the mortality rate is much worse for covid-19 which by extension raises the stakes in the event that it mutates even slightly and the predicted (hoped for) herd immunity and eventual vaccine proves less effective than we would like. Hence my (admittedly as a lay person) preference for fewer people getting it in the first place.

[highrepute]

Flu and Corona (and common cold) are both viruses. They behave in the same way. I think it sounds quite scary to say you can get corona-virus multiple times and if you have immunity it only last a year. But saying the same about flu doesn't seem so bad because we know it to be the case and we live with it every year.

The quote doesn't say that immunity only lasts a year, it says that people with other corona viruses have been purposely, successfully and symptomatically reinfected after a year. A straight reading of the quote does not imply that that re-infection could not have occurred earlier or that there was any immunity developed prior to reinfection.

The situation is different to flu, because Covid-19 is many times worse in terms of mortality and morbidity (I note very little is being said about survivors that are left with significant lung and other organ damage) and because the whole point of the government strategy is an assumption that immunity is developed so that widespread infection is desirable. The point of the quote was to question the basis of that assumption.

This is the full quote.

The best studied of the non-SARS coronaviruses, human coronaviruses 229E and OC43, cause respiratory symptoms, such as rhinorrhea, nasal congestion, sore throat, and cough, as well as systemic symptoms, including fever, headache, and malaise, when they are inoculated intranasally in adult volunteers. Symptoms develop 2 to 4 days after inoculation, but about 30% of the volunteers who excrete virus had no associated illness. Symptoms usually persist for about 1 week but sometimes for as long as 3 weeks. Previous infection does not induce high levels of protective immunity. Humans can be reinfected with respiratory coronaviruses throughout life, and human volunteers can be symptomatically reinfected with the same strain of coronavirus 1 year after the first infection.

Sounds quite scary right, as you are pointing out?

human coronaviruses 229E and OC43 are type of the common cold. Now doesn't sound quite as scary. Which is my point - that it's easy to make this sound scary.

But I get your point, which I missed before. There are types of coronavirus that once you've had don't induce "high levels of protective immunity". I guess my next question is what does "high levels" mean?

[Ru]

Sounds quite scary right, as you are pointing out?

human coronaviruses 229E and OC43 are type of the common cold. Now doesn't sound quite as scary. Which is my point - that it's easy to make this sound scary.

But I get your point, which I missed before. There are types of coronavirus that once you've had don't induce "high levels of protective immunity". I guess my next question is what does "high levels" mean?

Exactly. I'm not concerned about how "scary" it sounds, I wondering what evidence the government has to support an aim of getting 60% of the population to contract Covid-19 so we get herd immunity.

[Will Hunt]

My sister-in-law lives in Southend with her husband and two young kids. They're down to their last bog roll and the shop's shelves are bare. Things are about to get ugly in that house.

[wasbeen]

I am wondering if the government's thinking is that the virus could be (much) less lethal than assumed?

Cases are much more likely to be under reported than over reported and deaths are likely to be (pretty) accurately reported.

Based on the government's estimate of 5000-10000 cases in the country, that puts the current mortality rate at between 0.1 and 0.2%. Countries with apparently have the most thorough contact tracing and testing (e.g. North Korea, Singapore, Malaysia) all have fatality rates lower than 1% and in some cases much lower. Even the Diamond Princess cruise ship 'only' had a rate of 1% and it would be hard to think of many more skewed demographics.

[Bonjoy]

Most UK cases are ongoing, the individual has neither died or recovered. The average time between onset of symptoms and death is about 17 day, so death figures will always be lagging behind eventual totals.
On a side note younger healthier folk take longer to succumb, so we wont know the true age spread of fatality in the UK for a good while yet.

[wasbeen]

Most UK cases are ongoing, the individual has neither died or recovered. The average time between onset of symptoms and death is about 17 day, so death figures will always be lagging behind eventual totals.
On a side note younger healthier folk take longer to succumb, so we wont know the true age spread of fatality in the UK for a good while yet.

The point I was trying to make is our government don't have a clue how many cases there are and this is the case for every other European country. None more so than Italy where the number of confirmed cases is probably limited by the number of people they can test in a day.

The most accurate figures are likely to be where the testing captures the highest proportion of the people infected. Leading on from this, the most accurate mortality rates are for the countries with the lowest mortality rates.

Or perhaps I am just an optimist!

[petejh]

I'm not sure if 'optimist' is the best descriptor of saying death rate is 1% of a massive number. Better that than 2% though!

Interesting the difference in opinion from different colleagues in the office today. Lets just say I wouldn't want to be the parents of some of them!

Ru, might be relevant to consider if there are significant differences in how an infection behaves in a giant country such as China with huge areas of empty land between population centres, versus how it behaves in densely-populated central Europe/the UK. And therefore differences in what's realistic to achieve and what the best approach is. But then again aren't Singapore, Taiwan and Hong Kong comparable to us in density (more so)..? Seems there are two diverging mindsets - those who wish we were Taiwan/Singapore/HK etc. and containing any spread, and those who think we have to let it spread but in as controlled a manner as possible. Like you say it'll be interesting to see what the justifications are based on.

[Paul B]

This fall firmly under 1st world problems but the Institution with which I have a review next week announced on Tues that they'd be starting daily update bulletins that day, and if not, the next day at the latest (Wed).

It's Fri now and nobody has heard anything. I've contacted them this morning saying essentially I assume the radio silence means you're not intending to cancel yet the radio silence continues (in contrast the previous reply was received in under 5 mins). I don't know what to make of this other than people seem wary of accepting the Gov's stance on social distancing.

  

[Bonjoy]

It strikes me that based on the case/fatality rates and comparisons with other countries, we already have more than our health system can cope with baked into the cake. It would now take very aggressive control measures to 'flatten the peak' and there is little sign of this from the govt. It seems like all the talk of spreading the load over time is either BS to calm the public or based on flawed over-optimistic analysis.

[Will Hunt]

Singapore is a large, world city where people generally live in densely populated high-rise buildings. Apartments often have very little in the way of a kitchen and people eat instead in the relatively cheap hawker centres that are in every high-rise.

The reason that we aren't seeing the spread there and in other similar countries, where conditions are otherwise good for spreading infection (humidity notwithstanding), is that they had SARS in 2003 and they learned. My brother, who lives there, reports that every office building and shop seems to have a heat sensitive camera at the entrance and people are tested for high-temperature wherever they go (in a non-intrusive way). Clearly this tech has been bought since 2003 and maintained and updated, ready for another such eventuality. The authorities are highly-geared towards contact tracing. The population is more inclined to wear effective masks (I think westerners tend to look at these in a bemused way as just another way that east is peculiar to west. That attitude might well change).

Social distancing is an effective way to slow the spread of the virus to much more manageable levels. The thinking is that the UK population won't put up with it. We might well be prepared to do things differently in the pandemic of 2037.

[wasbeen]

I'm not sure if 'optimist' is the best descriptor of saying death rate is 1% of a massive number. Better that than 2% though!

I think it is more like 0.5%

https://www.sciencenews.org/article/coronavirus-outbreak-diamond-princess-cruise-ship-death-rate

[tommytwotone]

Overheard my sister-in-law talking to a medic friend in school playground today. He was saying that while testing is going on at hospitals, due to time it takes to get kitted out in protection for the swabbers, they can do 12 a day max.

[andy popp]

He was saying that while testing is going on at hospitals, due to time it takes to get kitted out in protection for the swabbers, they can do 12 a day max.

The US tested eight people on Tuesday.

[andy popp]

From what I've just seen (not completely verified but I think it's true) Denmark is closing its borders tomorrow.